In the last edition of the Update I wrote about the Health
Alliance of Greater Cincinnati losing their bid to force several hospitals to
stay in their organization. Now they state the real reason why the
hospitals were wanted was money. They implied that by eliminating jobs and
shifting oversight away from the Alliance to the individual hospitals for ED
work. Their greed continues.

Computers are wonderful. Northern Cochise Community
Hospital of Wilcox, Arizona recently had bills to out to 587 patients for
amounts up to $49 million. The hospital sends the amounts to Healthcare
Management Systems in Nashville who screwed up. They sent the erroneous
bills but did not do their due diligence by checking the bills for accuracy.

St. Vincent Indianapolis has compromised the privacy of about
51,000 people by placing their names, addresses and SSNs on the internet.
The people have been notified and provided with a free credit report as well as
free monitoring. Top

Physicians

The Miami Herald had a story regarding a heart surgeon, Dr.
Alex Zakharia, who was apparently summarily suspended from Cedars Medical Center
while an investigation into his cases continues. He has challenged the
suspension in court. He has also been accused of fraud and perjury for
allegedly exaggerating his surgical experience when he testified in a med mal
case. The physician apparently also suffers from memory lapses that may or
may not effect his work. He continues to work at four other hospitals
without any known problems.

The Wall Street Journal had a front page article that said as
Medicaid payments drop less numbers of physicians will see the patients. I
hope they didn't spend too many resources on the obvious.

For those physicians and their employers who do not know,
you MUST write ALL Medicaid prescriptions on tamper-resistant pads. CMS
has been asked by the pharmacists to delay implementation. CMS has said
no. This was a small paragraph in the entire funding bill for the Iraq
war.

Physicians are human and they suffer when an error is
made. In a study of over 3000 physicians, 2000 said they had made
errors. The other 1000 had never seen a patient or lied. Out of the
2000 truthful physicians about 60% had anxiety over possible future mistakes,
44% had less confidence in themselves and 42% had sleep problems. Only 10%
stated that the hospital was supportive regarding their stress. Many
hospitals won't even let physicians discuss mistakes. Sort of gives you a
picture of a warm and friendly hospital administrator.

Sicko is alive and well. I saw the movie over the
weekend and on Monday read an article that confirms the premise that insurers
are evil. The LA Times has an article that Blue Cross, the largest private
insurer in California, will unilaterally and without discussion slash the rates
paid to physicians. It is my hope that many physicians who are not too
afraid of their getting paid less than cost will drop the plan. They can
still see the patients but the patients will pay more out of pocket to see a out
of contract physician. If enough patients get angry enough maybe Blue
Cross will get the message. That however is
doubtful. Top

Insurers

Blue Cross of California has has over 1600 complaints against
it from its insured and physicians over the past three years. A hearing on the
matter was supposed to happen in July but has been postponed until August
because the parent, WellPoint has requested a more detailed agenda. Most
of the complaints are those of Blue Cross not paying the physicians enough under
their contracts nor quickly enough.

California Blue Shield has started to limit the use of
erythropoietin stimulating drugs. This supposedly is because of the side effects
but all know it is due to money. The change effects those on chemotherapy with
lower hemoglobins needed to justify the usage and the denial of those with
cancer off chemotherapy. They are waiting on a decision regarding kidney
dialysis patients.

The VA is taking justifiable hits. The head has
resigned, the courts have raked it and now a report shows the problems with
disability payments. The report blasts the VA for not keeping track of the
number of claims and the number rejected. They point out the disparity in
dollars paid out per claim between states. The Congress, never known to
let reasonableness get in the way of practicality, is about to shift more work
on the poorly staffed VA system. Top

Fraud

The feds are pushing to find and prosecute those in the
healthcare field that are billing for phony care or providing excessive
treatments. Medical supply companies will be required to reapply and
certify that the executives are clean. Most of the fraud is in urban
centers such as Miami and Los Angeles.
Top

DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.